Histopathological and clinicoradiological correlation in esophageal neoplasm and 2-year institutional experience in minimally invasive surgery.

Abstract

151 Background: Esophageal cancers, primarily esophageal adenocarcinoma and squamous cell carcinoma (SCC), present diverse clinical, radiological, and histopathological features. Comprehending these characteristics is crucial for effective detection, diagnosis, staging, and treatment planning. This study investigates the correlation between histopathological features and clinicoradiological findings in esophageal neoplasms, focusing on the prognostic significance of histological subtypes and their impact on survival outcomes. Methods: A retrospective study was conducted on 57 patients with various esophageal cancer histologies who underwent minimally invasive esophagectomy, with or without prior chemoradiation. Pathological evaluations included dysplasia, invasive tumor presence, nodal involvement, grading, lymphovascular and perineural invasion, and pathological complete response. Imaging features were analyzed and correlated with histopathological findings. Outcomes were assessed based on nodal recurrence, 2-year overall survival, and mortality rates. Results: Both histologies (adenocarcinoma and SCC) exhibited similar cross-sectional imaging features, including wall thickening and FDG PET uptake. Barium examinations revealed infiltrating lesions with irregular luminal narrowing, ulceration, and abrupt tumor margins in both types. Poor differentiation, lymphovascular invasion, and nodal involvement were associated with poor outcomes. Conclusions: The study highlights the importance of understanding imaging appearances and pathological bases of esophageal neoplasms for accurate diagnosis, staging, and treatment planning. Histological parameters like vascular and perineural invasion, and nodal involvement, significantly influence prognosis. Further research is needed to establish the prognostic role of specific histological subtypes fully. Clinicopathological profile and surgical outcomes (n = 57). Parameter Overall (n=57) SCC (n=36) Adenocarcinoma (n=18) Mixed (n=3) Mean Age (years) 58.4 – – – Male 40 (70.2%) – – – Female 17 (29.8%) – – – Mid Esophagus 30 (52.6%) 25 (69.4%) 2 (11.1%) 3 (100%) Lower Esophagus 27 (47.4%) 11 (30.6%) 16 (88.9%) 0 Well Differentiated 6 (10.5%) 2 (5.6%) 4 (22.2%) 0 Moderately Differentiated 43 (75.4%) 31 (86.1%) 9 (50.0%) 3 (100%) Poorly Differentiated 8 (14.0%) 3 (8.3%) 5 (27.8%) 0 Mean Lymph Nodes Harvested 22.1 – – – Nodal Positivity 13 (22.8%) 2 (5.6%) 11 (61.1%) 0 Lymphovascular Invasion (LVI) 13 (22.8%) 0 13 (72.2%) 0 Perineural Invasion (PNI) 7 (12.3%) 2 (5.6%) 5 (27.8%) 0 Robotic Surgery 17 (29.8%) – – – VATS 40 (70.2%) – – – Converted to Open 2 (3.5%) – – –